Forms for Allele Diagnostics

Medical Records Release Form

Please use our medical records release form if you wish to request a report from our laboratory on a patient your office is seeing. Please note that if your request is urgent, it is advisable to call our laboratory to discuss your request directly with a genetic counselor or laboratory management so we can expedite your request.

Requisition Forms

All Allele requisition forms for both prenatal and postnatal testing are located on our requisitions page.

Specimen Release Form

Our specimen release form can be used if you wish Allele to share a stored sample with another laboratory. When you wish us to send the sample, please fax us the completed form and a copy of the completed test requisition form or shipping paperwork for the laboratory that will be receiving the sample.

Test Revision Form

Our test revision form can be used to cancel testing, add testing to an existing order or stored specimen, or modify testing that has been ordered. Please note that if you wish to cancel or modify testing that is in progress, we advise contacting the laboratory to see if the testing is at a point where it can still be cancelled or modified prior to completing and sending the form.